Diabetes in the African

American Community
Group 4: Carmelie Jean-Pierre, Samantha Verne, Rebekah Antoine
Florida International University
PHC 6412: Health Promotion in Diverse Communities
 Public Health Issue

 Diabetes is a condition where a person’s body does not properly process food to be used as
energy. Diabetes occurs when the body does not make adequate insulin or when the body
cannot use the insulin properly, thus causing the glucose to build up in the individual’s
blood.

 African American adults are 60 percent more likely than non-Hispanic white adults to have
been diagnosed with diabetes by a physician (Center for Disease Control and Prevention,
2020).

 In 2017, African Americans were twice as likely as non-Hispanic whites to die from
diabetes (Center for Disease Control and Prevention, 2020).
Public Health Issue

Diagnosed Cases Death Rates

Health Disparities: Diabetes in African Americans

Diabetes complications affect African American

communities disproportionally. African
Americans, compared with non-Hispanic Whites,
are
1) Twice as likely to be diagnosed with
diabetes,
2) More likely to have high blood pressure and
obesity
3) More likely to suffer from diabetes
complications such as blindness, kidney
disease, and amputations (CarePath Healthy
Engagements, 2016).
 Genetics, personal
Social Environment characteristics &
behaviors.
Determinants of
Health:
The range of personal, social,
economic, and environmental factors
that influence health status.

Economic Environment Physical Environment

 These environmental, social, 6
and economic factors
powerfully influence health
outcomes for entire
populations (Office of Health
Equity, 2016).
 Medical care, healthy
behaviors, and genes and
biology altogether account
for only about half of a
society’s overall health
outcomes (Office of Health
Equity, 2016).
 The other half is made up of
those social determinants of
health that provide or limit
the opportunities for health
(Office of Health Equity,
2016).
 Determinants of
Health
There are several determinants
that cause diabetes to be more
prevalent in the African
American community.

 Obesity
 Culture & Diet
 Genetic Traits & Insulin
Resistance
 Physical Inactivity
 Lack of access to health care
 Lack of access to healthy foods
 Lack of Transportation
 Chemical pollution exposure
 Determinants of Health: Obesity

African American people tend to eat foods higher in fat such as fried
foods. This type of diet will lead to obesity. Eating soul food is common in
the African American culture. A typical soul food platter can consist of
foods like:
 Baked macaroni and cheese
 Fried chicken
 Candied yams
 Corn bread
 Determinants of Health: Access to Healthy Food

African American people who live in poorer communities have a very

limited access to healthier options such as fruits and vegetables. It is
very common that in these neighborhoods, fast food is readily
available, however, grocery stores like Whole Foods and farmer
markets are limited. African American urban neighborhoods are
reported to have only 41% of the chain supermarkets found in
comparable white neighborhoods (Jack, Jack & Hayes, 2012).
 Determinants of Health: Lack of Transportation

This is cause for worry because individuals will not be able to:

 Attend their doctor appointments

 Go to the gym
 Travel to nearby neighborhoods to go to the supermarket and access
healthy foods
 Determinants of Health: Lack of Health
Insurance

 Lack of health insurance can be defined as no health insurance or being underinsured.

 Diabetes treatment can be very expensive leaving individuals with a high bill even after
insurance covers a portion.

 As of 2018, the uninsured rate among African Americans was 9.7 percent, while it was
just 5.4 percent among whites (Shaw-Perry, 2007).

 Almost one out of every five African American lacks health insurance. Both being
uninsured and underinsured significantly reduces their ability to manage their health
and subsequently their blood sugar levels.
Long-term Impact of 12
African Americans are 46% more likely of developing
Diabetes in African diabetic retinopathy than Caucasian Americans

American
Communities End stage renal disease due to diabetes is about 2.6 times
 Lack of healthcare and lack of more likely for African Americans than Caucasian Americans
transportation causes African
American people to not
properly care for their diabetes. The mortality rate for African Americans from cardiovascular
disease and acute stroke is higher compared to Caucasian
 These barriers lead to African Americans
American people are more
likely to suffer from
complications due to diabetes African Americans have an increased risk for lower
than whites. extremity amputations compared with Caucasian Americans
 Untreated or improperly
management of Diabetes has a
serious long-term impact in African American women have a 52% increase of
African Americans. developing type 2 diabetes in the future once they are
diagnosed with gestational diabetes
 Leading Causes of 13
Death in African
Americans
 People with diabetes are also more
likely to have other conditions that
increase the risk of heart disease
and stroke, such as high blood
pressure and obesity.
 African Americans are more likely
to have diagnosed or undiagnosed
diabetes than Caucasian Americans
and are less likely to adhere to
treatment, which leads to higher
rates of diabetes related deaths.
 Diabetes is the third leading cause
of death in African Americans
(Shaw-Perry, 2006).
 African Americans are 2.3 times
more likely to die from diabetes
compared to Caucasian Americans
(Spanakis and Golden, 2013).
 An Epidemic within a Pandemic
Diabetes + COVID-19 in African American Communities

 Diabetes related complications and deaths puts an

additional strain on the African American community’s
overall health and quality of life.
 The COVID-19 Pandemic has become a double
challenge for people with diabetes. Diabetes is listed as
one of the main pre-existing health issues and risk
factor for the severity, hospitalization and mortality of
the COVID-19.
 Diabetes is even currently playing a role in the
hospitalization and death of African Americans due to
Covid-19.
 COVID-19 is disproportionately affecting African
Americans. The pandemic is shedding light on the
economic and racial disparity across the United States
where many African American communities still face
financial, economic, health and cultural barriers.
Key Messaging for Diabetes Prevention & Management

 Culture, background, and lifestyle have a significant

influence on diabetes management in African
Americans. It has been proven that barriers to self-
management in African Americans with diabetes
include misunderstanding of the disease, impact of
diet, coping skills, and underestimating the gravity of
the disease. (Gould, Kelly, Goldstone, & Gammon,
2001).
 It is important for the diabetes interventions to be
culturally sensitive and consider aspects such as
traditional foods and religion in order for them to be
effective.
 Diabetes Prevention and Management Programs must
take into account culturally acceptable practices, other
health problems, socio-economic environment, mental
health and their overall lived experiences as a Black
person in America.
 Diabetes Interventions
Church Intervention:
This intervention focused on education,
physical activity, emotional support,
and behavioral management
specifically in African Americans in a
church setting. Results showed that the
participants were adhering more to
their medication and foot care protocol.
Findings also showed that there was a
significant decrease in systolic blood
pressure and waist circumference
(Collins-McNeil et al., 2012).
Charlotte REACH 2010:
This intervention focused on reaching
African Americans in the Charlotte,
North Carolina area. This intervention
had five tiers of influence:
intrapersonal, interpersonal,
organizational, institutional, and
community. This intervention resulted
in an increase of knowledge in
preventive health behaviors and an
increase in physical activity among the
participants (Center for Disease Control
 Diabetes Interventions
NEEMA Program:
This intervention focused on African American
children. It was a school-based diabetes program
that provided teachers with culturally sensitive
information on physical education to help revise
the health curriculum at the school. The purpose
of this intervention was to increase physical
activity and improve diet. The teachers were
educated on nutrition, physical activity, self-
control, and diabetes, families were educated on
healthy eating choices and invited to meetings
with aerobic exercises, and the cafeteria staff was
educated on encouraging students to make
healthier lunch choices.
Language & Literacy:
This intervention assessed whether language
and literacy influenced diabetes management
in African Americans. The findings of this
intervention concluded that having diabetes
management education delivered in lay terms
and in different languages resulted in an
overall decrease of blood glucose (Rawlins,
Toscano-Garand, & Graham, 2017).
Additionally, this program also resulted in cost
savings due to the overall reductions in
diabetic complications. The participants in this
intervention showed high satisfaction rates
and continued attendance throughout the
intervention.
 Possible Improvements

 Future diabetes screening, prevention, and management programs should adopt holistic
and comprehensive approaches to care and consider how belief systems, culture,
institutional policies & practices, living conditions, health behaviors and psychosocial
factors impacts African Americans’ health and well-being.
 Culturally- sensitive focused approaches will result in a significant increase of program
satisfaction and adherence.
 Considering language and the use of lay terms will increase understanding
 Establishing interventions at local churches, community centers, schools, WIC clinics
and health centers/clinics can also increase participation and reduce the need to travel
to multiple locations.
 Providing nutritious and healthy cultural recipes in future interventions will facilitate
adherence.
 References

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